Balneotherapy
Balneotherapy is a therapeutic practice that involves the use of hot and cold baths, saunas, mud packs, and other water-based treatments to promote health and wellness. This ancient practice has roots that trace back to early civilization and naturopathy, evolving into a more structured approach known as hydropathy. Today, balneotherapy is often utilized for managing conditions such as arthritis (including rheumatoid arthritis and osteoarthritis), low back pain, and may also be considered for ailments like eczema, fibromyalgia, and psoriasis.
Certain types of mineral-rich waters, such as sulfur springs and saline lake waters, are particularly favored in balneotherapy, as some practitioners believe they possess unique healing properties. Despite various studies examining its efficacy, the scientific support for balneotherapy remains inconclusive, largely due to challenges in conducting reliable research, such as the difficulty of maintaining participant blinding. While some evidence suggests that balneotherapy may alleviate symptoms and enhance quality of life for certain conditions, it is important to note that it is not a replacement for conventional medical treatments.
Safety considerations are crucial, as excessive exposure to hot baths can pose risks for vulnerable populations, including pregnant women and those with serious health issues. Overall, balneotherapy is best viewed as a complementary therapy, offering potential benefits alongside other medical interventions.
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Subject Terms
Balneotherapy
DEFINITION: Treatment using hot and cold baths, saunas, mud packs, and other therapies.
PRINCIPAL PROPOSED USES: Arthritis (rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis), low back pain
OTHER PROPOSED USES: Eczema, fibromyalgia, Parkinson’s disease, psoriasis, varicose veins, acne, asthma, chronic obstructive pulmonary disease (COPD), stress, anxiety
Overview
The use of hot and cold baths for treating illnesses goes back to the dawn of civilization. In later centuries, early practitioners of what would become naturopathy popularized the use of hot springs and water in other forms. From these practices, a formal system of medicine known as hydropathy developed. Today, mud packs, saunas, and steam baths are often included along with water baths under the general name of “balneotherapy.”
Certain types of water are often particularly prized by balneotherapy practitioners. These include sulfur springs and the concentrated salty water of drying lake beds, such as the Dead Sea (in Israel). Some proponents also say hot springs high in the radioactive substance radon possess particular healing properties.
Scientific Evidence
Although various forms of balneotherapy have undergone some scientific study, none of this evidence is reliable. There are many causes of the inadequacies in the research record, but one is intrinsic and probably not correctable. This is the problem of blinding.
For the results of a study to be reliable, participants and researchers must be kept in the dark (“blind”) regarding who received the treatment under study (the active group) and who received a placebo treatment (the control group). If practitioners and researchers know who is in which group, numerous confounding factors take over and produce misleading results. These factors include observer bias, reporting bias, and the placebo effect. To briefly summarize this complex issue, one could say that unblinded studies usually mean little to nothing.
It is challenging to keep study participants from knowing they have taken a hot bath. Some researchers have used ordinary tap water as a comparison with special mineral water. If, as was the case in some studies, the active treatment smelled of sulfur or (as in other studies) it was so dense with minerals that it made the skin tingle and the body float high in the water, participants would have been able to determine what group they were in. This would effectively destroy blinding and would fundamentally compromise the study results. Given these caveats, there is evidence that balneotherapy of various kinds might be helpful for conditions such as ankylosing spondylitis, fibromyalgia, low back pain, osteoarthritis, psoriasis, rheumatoid arthritis, and varicose veins. Balneotherapy is also said to be helpful for eczema, Parkinson’s disease, and numerous other conditions, but for these conditions, the therapy lacks even unreliable supporting evidence. If it does work, balneotherapy could act locally (on muscles, joints, and skin) through the effects of heat, and systemically through the absorption of substances, such as sulfur through the skin.
Balneotherapy should be considered a complement to other medicines and therapies for the conditions for which it is suggested. Balneotherapy may improve the quality of life and lessen the symptoms of a condition, but it is not a cure for any medical condition.
Safety Issues
Excessive immersion in hot baths can be dangerous for pregnant women, young children, those with a heart condition or other serious medical illness, and people under the influence of alcohol or other intoxicating substances. There are also concerns that hot springs high in radon might present a cancer risk, though this has not been proven.
Bibliography
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Codish, S., et al. "Mud Compress Therapy for the Hands of Patients with Rheumatoid Arthritis." Rheumatology International, vol. 25, 2005, pp. 49-54.
Cozzi, F., et al. "Mud-Bath Treatment in Spondylitis Associated with Inflammatory Bowel Disease." Joint, Bone, Spine, vol. 74, 2007, pp. 436-439.
Dawe, R. S., et al. "A Randomized Controlled Comparison of the Efficacy of Dead Sea Salt Balneophototherapy vs. Narrowband Ultraviolet B Monotherapy for Chronic Plaque Psoriasis." British Journal of Dermatology, vol. 153, 2005, pp. 613-619
McVeigh, J. G., et al. "The Effectiveness of Hydrotherapy in the Management of Fibromyalgia Syndrome." Rheumatology International, vol. 29, 2008, pp. 119-130.
Mourelle, M. L., et al. "Unveiling the Role of Minerals and Trace Elements of Thermal Waters in Skin Health." Applied Sciences, vol. 14, no. 14, 2024, p. 6291, doi.org/10.3390/app14146291. Accessed 4 Sept. 2024.
Pittler, M. H., et al. "Spa Therapy and Balneotherapy for Treating Low Back Pain." Rheumatology, vol. 45, 2006, pp. 880-884.
Reger, Maren, et al. "Water Therapies (Hydrotherapy, Balneotherapy or Aqua Therapy) for Patients with Cancer: A Systematic Review." Journal of Cancer Research and Clinical Oncology, vol. 148, no. 6, 2022, pp. 1277-1297, doi:10.1007/s00432-022-03947-w.
Yurtkuran, M., et al. "Balneotherapy and Tap Water Therapy in the Treatment of Knee Osteoarthritis." Rheumatology International, vol. 27, 2006, pp. 19-27.